Kathryn Sexton, 23, who is from an upper-middle-class family, had landed a full scholarship to college. She dropped out after she began using heroin and ended up working as a cocktail waitress at a gentleman's club.

Katiena and Roger Johnson have been parenting their two grandkids. Their 26-year-old daughter, Destini, went to jail on drug charges.

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Originally published on September 22, 2017 3:33 pm

Jonathan Guffey has chiseled youthful looks and, at 32, does not have the haggard bearing of someone who has spent more than half his life hooked on opioids. That stint with the drug started at 15 and ended — he says for good — 22 months ago. He has a job working with his family in construction, but his work history is pockmarked by addiction.

"I've worked in a couple of factories for a short amount of time, probably just long enough to get the first check to get high off of," Guffey says.

I met Guffey at Road to Redemption, a weekly free dinner and support meeting at a church in Muncie, Ind., for people in, or seeking, recovery. He says his habit was enabled by other users — family, friends, even a boss at a factory where he once worked.

"There [were] plenty of times when I wouldn't go to work there, and my boss would call me and he wouldn't even say anything about work, he would just want more opiates ... pills or whatever it was that I could get at the time," Guffey says.

Economists estimate 1.5 million working-age people are missing from the labor force, not working or looking for work. It is not clear to what extent the country's heroin and opioid painkiller epidemic is affecting declining participation, especially among prime-age men, those 25 to 54. But in many communities such as Muncie, it is clear that the proliferation of opioid abuse is having a big enough impact for employers and the community to take notice.

Those with opioid addictions tell strikingly similar stories, in which work takes a back seat to an intensifying compulsion for the drug. They're sleepy on them, and horribly sick when they aren't. They say the physical impact is worse than with other drugs. Those I interviewed described a deepening alienation that ultimately includes both family and work. In lieu of jobs, most say they eventually supported themselves by dealing drugs.

"I lived and breathed drugs" and shunned both work and relationships, says Jennifer Smith, who shows me a mug shot of herself taken six months ago, just before she got sober. In it, she is thinner, with dark bags under her eyes, looking a decade older than her 40 years. She says that before the opioids, she worked as a bartender but went years without a job once she started using.

"It feels like I lost a lifetime," she says.

Opioid use is less common and, in the aggregate, less lethal than alcohol. But the data show opioids affect users' work life more. Research from the National Safety Council and the independent research institution, NORC at the University of Chicago, show opioid users miss twice as many days of work than those with alcohol addiction. According to Princeton economist Alan Krueger, 47 percent of prime-age men not in the labor force used pain medication — and two-thirds of that subgroup used prescription drugs.

Melissa Wallace's ex-husband and three children all wrestle with various addictions. She also owns a small cleaning business that hires some people in recovery, so she has seen how the disease affects both workers and employers.

"There is the trust issue," she says. "Even if they're clean, can I trust this person in people's homes or businesses? Oftentimes they relapse, so there's reliability — are they going to show up?"

Wallace, who works for Road to Redemption, says opioid addiction strikes the rich, the poor and the promising.

"I know a lot of my kids' friends have fallen into that trap — in and out of jail," she says. "Kids that, if you would've told me 10 years ago would have ended up in jail, I would've just been like, 'no way.' "

She might as well be talking about Kathryn Sexton. Sexton is a tall 23-year-old from an upper-middle-class family whose perfect high school grades landed her a full-ride college scholarship.

"And that's where I met heroin," she says. "Next thing I know, I'm cocktail waitressing in a gentlemen's club, and it was instant money — and those are the types of things I would've never imagined myself doing."

She dropped out of college. She says among her circle of a dozen high school friends, seven are dead of opioid overdoses, or related car accidents or medical crises. Sexton sobered up a month ago, only to confront a felony possession charge that might cost her a nursing assistant's license — the only thing remaining of her career plans.

What's more, she says, it might mean she won't be able to go back to school, possibly ever.

"If these charges stick, I will not be able to get any federal loans, because they don't give them to felons," Sexton says.

A families point out, it's not just the addicted whose careers suffer.

I meet Roger and Katiena Johnson on their front lawn, strewn with kids' toys — evidence they've been thrust back into parenting as they care for their two grandkids. Their 26-year-old daughter, Destini, went to jail on drug charges — but they describe her as a once-hard-working teenager who previously had a job at the same company as her father.

"She's worked with me twice, when she was 16 years old and going to school," says Roger Johnson. "So, I mean, once this drug gets hold of you, it brings you down."

Katiena Johnson says that she missed workdays driving Destini to rehab and doctors and that dealing with opioid addiction interrupted her own plans.

"Once you raise your kids, you want to be able to retire or something," she says. "We weren't able to; we went ahead and took on our grandkids," she says, before being interrupted by someone yelling, "Hey," in front of the house.

It's Destini Johnson, released unexpectedly early because, she tells her parents, the jail was overcrowded. Her mother, who works the overnight shift at a local children's home, wears an expression that is both happy and worried because Destini wasn't given a shot to control her opioid cravings. And once again, Katiena Johnson is rethinking her work schedule.

"Kind of makes me want to stay home tonight, just to make sure she doesn't use," she says, adding that she'll lean on other family members if necessary.

Destini Johnson surveys the doghouse where she slept when her parents evicted her for using in the house. She points to the side entrance of her parents' home, which is blocked by bags of her old clothes and other items she used to drag around when she was strung out and homeless.

She says sobriety in jail made her realize she wants a good job, but that in the past, addiction meant she was also hooked on making the quick buck.

"I'd rather go and trick," she says, looking at me. "I don't know if you know what that is, but you know, have sex for money to get my drugs, because it was a lot faster and easier.

"You have to wait a whole week for a paycheck — no addict wants to wait that long to get their drugs."

Katiena Johnson urges her daughter to take it slowly — to focus on recovery before worrying about applying for jobs. Rejection, she worries, might make Destini resort to using once again.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

MARY LOUISE KELLY, HOST:

All right, let's talk about the estimated one and a half million unemployed Americans who have stopped looking for jobs, even though there are plenty available. This week, NPR's Yuki Noguchi has been asking how much the opioid epidemic contributes to that. She's looking at the drug's impact on Muncie, Ind.

YUKI NOGUCHI, BYLINE: Jonathan Guffey has chiseled, youthful looks and, at 32, does not have the haggard bearing of someone who's spent more than half his life hooked on opioids. That stint with the drug started at 15 and ended, he says, for good, 22 months ago. He now works in construction, but his work history is pockmarked by addiction.

JONATHAN GUFFEY: I've worked in a couple factories for a short amount of time, probably just long enough to get the first check to get high off of.

NOGUCHI: I meet Guffey at Road to Redemption, a free weekly dinner and support meeting in Muncie for people in recovery. He says his habit was enabled by other users - family, friends, even a boss at a factory where he once worked.

GUFFEY: And there was plenty times when I wouldn't go to work there, and my boss would call me. And he wouldn't even say anything about work. He would just want more opiates, pills or whatever it was that I could get at the time.

NOGUCHI: Those with opioid addictions tell strikingly similar stories, where work takes a back seat to an intensifying compulsion to use. They're sleepy on them and horribly sick when they aren't. They say the physical impact is worse than with other drugs. Those I interviewed describe a deepening alienation that ultimately includes both family and work. Most say they eventually supported themselves by dealing drugs. Opioid use is less common and, in the aggregate, less lethal than alcohol. But the data show opioids effect users' work life more.

The National Safety Council and the Nork Research group at the University of Chicago show opioid users miss twice as many days of work than those with alcohol or other drug addictions. Princeton economist Alan Krueger released a study this week linking about 20 percent of recent declines in labor-force participation to opioids. His earlier research showed nearly half of prime-aged men absent from the labor force used pain medication, mostly opioids.

Melissa Wallace's ex-husband and three children all wrestle with various addictions. She also owns a small cleaning business that hires some people in recovery.

MELISSA WALLACE: Oftentimes, they relapse. So there's reliability. Are they going to show up?

NOGUCHI: Wallace, who works for a Road to Redemption, says opioids strike the rich, the poor and the promising.

WALLACE: I know a lot of my kids' friends have fallen into that trap, in and out of jail - kids that if you would've told me 10 years ago would have ended up in jail, I would have just been like, no way.

NOGUCHI: She's referring to people like Kathryn Sexton, a tall, attractive 23-year-old from an upper-middle class family, whose perfect high school grades landed her a full-ride college scholarship.

KATHRYN SEXTON: And that's where I met heroin.

NOGUCHI: She dropped out of college. She says among her circle of a dozen high school friends, seven are dead of overdoses or drug-related car accidents and medical crises. Sexton sobered up a month ago, only to confront a felony possession charge that might cost her her nursing assistant's license, the only thing remaining of her career plan. It might also mean she won't be able to go back to school.

SEXTON: If these charges stick, I will not be able to get any federal loans because they don't give them to felons.

NOGUCHI: It's not just the addicted whose careers suffer. I meet Roger and Katiena Johnson in front of their house. The lawn is strewn with toys, evidence they've been thrust back into parenting their two grandchildren. Their 26-year-old daughter Destini went to jail on drug charges but once worked at the same company as her father.

ROGER JOHNSON: She's worked with me twice.

KATIENA JOHNSON: She worked there when she was 16.

R. JOHNSON: Yeah, when she was 16 years old and going to school. So I mean, you know, once this drug gets a hold of you, it's - it brings you down.

NOGUCHI: Katiena Johnson says she missed work driving Destini to rehab, to doctors and her own plans are on hold.

K. JOHNSON: No, I mean, once you raise your kids, you're wanting to, you know, retire or something, you know. We went ahead and took on our grandkids, in which - we love them.

UNIDENTIFIED CHILD: Hey.

K. JOHNSON: But this is my daughter.

R. JOHNSON: This is Destini.

K. JOHNSON: She - did you get out of jail?

DESTINI JOHNSON: Yes.

R. JOHNSON: She's right here.

K. JOHNSON: I love you.

R. JOHNSON: Sixty days.

NOGUCHI: Destini Johnson's homecoming is unexpected. Jail overcrowding, she says, led to her early release. Her mother, who works the overnight shift at a children's home, looks both happy and worried. Destini wasn't given a shot to control her opioid cravings. Once again, her mom rethinks her work plans.

K. JOHNSON: Kind of makes me even want to try to stay home tonight just to make sure she doesn't use.

NOGUCHI: Destini says she wants a good job. In the past, she says, addiction got her hooked on making the quick buck.

D. JOHNSON: I'd rather go and trick. I don't know if you know what that is but, you know, have sex for money to get my drugs because it was a lot faster and easier. You have to wait a whole week for a paycheck. No addict wants to wait that long to get their drugs.

NOGUCHI: Mom urges her daughter to take it slowly, focusing on recovery before applying for jobs. Rejection, she worries, might lead back to the drugs. Yuki Noguchi, NPR News, Muncie, Ind. Transcript provided by NPR, Copyright NPR.